A U.K. case study of who uses NHS direct: investigating the impact of age, gender, and deprivation on the utilization of NHS direct

Telemed J E Health. 2012 Nov;18(9):693-8. doi: 10.1089/tmj.2011.0256. Epub 2012 Oct 10.


Objectives: National Health Service (NHS) Direct provides a 24/7 telephone-based healthcare advice and information service to the public in England. Locally based studies have suggested variation in the uptake of this service among the United Kingdom's diverse population. This study seeks to examine this issue at a national level.

Subjects and methods: One month's period of national data was collected (July 2010) from the NHS Direct Clinical Assessment System for all 0845 4647 calls in England. Calls were matched to place of residence and were analyzed for age, gender, and deprivation using negative binominal regression.

Results: Within the context of NHS Direct the pattern of calls was highest for children 5 years old and under, with lowest call rates found for males and older people (65+ years old). Furthermore, call rates were lowest in the most deprived areas for children (0-15 years old). Gender differences were noted, whereby male call rates were higher in the most deprived areas for all age groups. Furthermore, call rates for or on behalf of older females (60+ years old) were lower in areas of extreme deprivation.

Conclusions: The findings suggest there is variation in usage of NHS Direct. Such usage appears to be influenced by age, gender, and deprivation. Further research is required to examine the underlying factors that contribute to variation in uptake of these services. This will enable the development of future promotional campaigns that can target particular sections of the population to encourage use of telephone-based health services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Confidence Intervals
  • Data Collection
  • England
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Poverty Areas*
  • Regression Analysis
  • State Medicine*
  • Telemedicine / statistics & numerical data*
  • Young Adult